Marriage and Family Life Among Millennials - #Michael A. Ayele (a.k.a) W - #City of Temple, Texas

2021- 2022 EFFECTIVE 10.1.21 - 9.30.22

Welcome The City of Temple is proud to provide you and your family with valuable and significant benefits. This Employee Benefits Guide was designed with you and your family in mind. This valuable reference guide, is an overview of the services and benefits available to you as an employee of the City of Temple. Please take the time to carefully review the guide for any changes or updates. Inside you will find the information you need to make informed decisions regarding the selection and continued management of your benefits for the 2021-2022 Plan Year.

Table of Contents 20 Flexible Spending Account 24 Income Protection 4 Getting Started 25 Survivor Benefits 5 Eligibility 26 Additional Voluntary Benefits 6 Qualifying Life Events 28 Employee Assistance Program 7 Medical Benefits 30 Retiree Benefits 8 Health Savings Account (HSA) 33 Glossary 11 Pharmacy Benefits 34 Required Notices 13 Medical Incentives / Premiums 40 Important Contacts 15 Know Where to Go 16 Dental Benefits 18 Vision Benefits 3

Getting Started Helpful Tips and Reminders FAQs – Be sure to choose the right coverage level, such as individual When Does Coverage Begin? or family. The elections you make are effective October 1, 2021 - September 30, 2022. – Gather the correct information for your dependents such as New Hires: Coverage starts 1st day of the month following 30 days from your date of hire. Employees who do social security numbers, birth dates, and smoking status for not elect benefits 15 days from their date of hire may have spouse. their benefit start date delayed. – Make sure your address and personal information is current. If I Am Already Enrolled and Not Making Any Changes, Do I Have to Complete the Open If your information is not up-to-date, you may miss out on Enrollment Process? important information such as insurance cards, plan documents, health notices, etc. Yes, this is an ACTIVE enrollment. You must re-submit your benefit elections, as previous elections will not roll over into – Need to change your beneficiary? Open Enrollment is an the new plan year. It is important that you review any rate or plan changes to your current plan. excellent time to ensure that the person designated as your Note: If you do not make any selections, you will not be beneficiary is correct regarding your insurance and covered for the 2021-2022 Plan Year. retirement benefits. If I Want to Decline Coverage, Do I still Need to – Visit each vendor’s website for additional information. Don’t Complete the Open Enrollment Process? forget to review each plan’s provider directory. If your Yes. It is important that Human Resources has a record of physician or doctor’s office is not considered In-network, you your decision. Keep in mind that if you decline coverage, cannot change or drop plans mid-year without a qualifying you won’t be able to elect coverage during the year unless life event. you have a qualifying event as defined on page 8. – You may select any combination of Medical, Dental and / or Can I Enroll My Spouse or Dependent on One Plan and Myself on Another? Vision plan coverage categories. For example, you could select Medical coverage for you and your entire family, but No. All covered dependents, including spouse, must be on select Dental and Vision coverage only for yourself. the same plan as the employee. – Benefits premiums are deducted on a pre-tax basis, which Can I Drop or Change Plans During the Plan Year? lessens your tax liability. No. Changes can only be made if there has been a qualifying life event as defined on page 8. – Avoid making quick decisions — enroll early! 4

Eligibility Who is Eligible? New Hire Coverage If you are a full-time employee of The City of Temple who is All benefit coverages will begin on the first of the month regularly scheduled to work 30 hours a week or more, you are following the first 30 days of employment for all enrolled eligible to participate in the Medical, Dental, Vision, Life, full-time employees. Disability, and various other benefits as listed in this guide. Things to Consider Eligible Dependents Take the following situations into account before you enroll to Dependents eligible for coverage include: make sure you have the right coverage. – Your legal spouse – Does your spouse have benefits coverage available through – Children up to age 26 (includes birth children, stepchildren, another employer? legally adopted children, children placed for adoption, – Did you get married, divorced or have a baby recently? foster children, and children for whom legal guardianship has been awarded to you or your spouse). If so, do you need to add or remove any dependent(s) and/or update your beneficiary designation? – Dependent children, regardless of age, provided he or she – Did any of your covered children reach their 26th birthday is incapable of self-support due to a mental or physical disability, is fully dependent on you for support as indicated this year? If so, they are no longer eligible for benefits on your federal tax return, and is approved by your Medical unless they meet specific criteria. Plan to continue coverage past age 26. Verification of dependent eligibility will be required upon enrollment. 5

Qualifying Life Events Due to IRS regulations, once you have made your choices for TIP: If you are currently the 2021-2022 Plan Year, you won’t be able change your benefits until the next open enrollment period unless you enrolled in family coverage, experience a Qualifying Life Event. new dependents are not When one of the following events occurs, you have 31 days automatically enrolled or from the date of the event to notify Human Resources and / or covered. request changes to your coverage through the online benefits portal. You must enroll them through the qualifying event process. – Change in your legal marital status (marriage, divorce, annulment, legal separation or death) – Change in the number of your dependents (for example, through birth or adoption, or if a child is no longer an eligible dependent) – Change in your dependent or spouse’s employment status (resulting in a loss or gain of coverage) – Change in your employment status from full time to part time, or part time to full time, resulting in a gain or loss of coverage – Entitlement to Medicare or Medicaid – Eligibility for coverage through the Marketplace – Change in your address or location that may affect the coverage for which you are eligible Your change in coverage must be consistent with your change in status. Please direct questions regarding specific life events and your ability to request changes to Human Resources. *The Participant will be required to reimburse The City of Temple, if it is determined that a child is or has become ineligible and The City of Temple has paid benefits. The City of Temple reserves the right to audit or request proof of dependent eligibility at any time. 6

Medical Benefits High Deductible Health Plan Summary The City of Temple offers two high deductible health plan options through Scott & White Health Plan. The chart below gives a summary of the 2021-2022 Medical coverage. Please refer to your Summary of Benefits & Coverage for full coverage details. HDHP HSA BS&W PREFERRED PLAN HDHP HSA BS&W + CIGNA PLAN (Employee Pays) (Employee Pays) In-Network Out-of-Network In-Network Out-of-Network ANNUAL DEDUCTIBLE (PLAN YEAR) Individual $3,500 Not Covered $3,500 $7,000 $7,000 $14,000 Family $7,000 Not Covered 80% 50% Coinsurance (Plan Pays) 80% Not Covered ANNUAL OUT-OF-POCKET MAXIMUM (Includes Deductible) Individual $5,000 Not Covered $5,000 $10,000 $10,000 $30,000 Family $10,000 Not Covered Lifetime Maximum Unlimited Not Covered Unlimited COPAYS / COINSURANCE Preventive Care No Charge Not Covered No Charge Not Covered 20% after deductible 50% after deductible Physician Office 20% after deductible Not Covered 20% after deductible 50% after deductible Specialist Office 20% after deductible Not Covered Telemedicine No Charge Not Covered No Charge Not Covered Virtual Visits The amount of the Not Covered The amount of the deductible or Not Covered deductible or copay may copay may not exceed the amount Urgent Care not exceed the amount of of the deductible or copay required Emergency Room the deductible or copay Hospital - Inpatient required for a comparable for a comparable medical service Hospital - Outpatient medical service provided provided through a face-to-face Diagnostic X-Ray through a face-to-face Diagnostic Lab consultation Complex Imaging consultation (CT Scans/MRIs) Prescription Drugs 20% after deductible 20% after deductible 20% after deductible 20% after deductible 20% after deductible Not Covered 20% after deductible 50% after deductible 20% after deductible Not Covered 20% after deductible 50% after deductible 20% after deductible Not Covered 20% after deductible 50% after deductible 20% after deductible Not Covered 20% after deductible 50% after deductible 20% after deductible Not Covered 20% after deductible 50% after deductible 20% after deductible Not Covered 20% after deductible 50% after deductible Utilizes BSW Extended PPO Network 7

Health Savings Account What Is a Health Savings Account? What Expenses Are Eligible for Reimbursement? A tax-advantaged personal savings account designed to – Copays complement a qualified High Deductible Health Plan (HDHP). – Deductibles You can use a Health Savings Account to pay for medical, – Coinsurance prescription drug, dental, vision, and other qualified expenses – Vision now or later in life. The funds can even be invested, making it a – Dental great addition to your retirement portfolio. – Certain Medical Supplies What Are the Tax Advantages of a Health For a complete list of eligible expenses, go to Savings Account? www.irs.gov/pub/irs-pdf/p502.pdf You are responsible for ensuring the money is spent on Funds contributed to a Health Savings Account are triple tax qualified purchases only and maintain records to withstand advantaged: IRS scrutiny. Funds used for non-qualified expenses are subject to income tax and an additional 20% tax. 1. Money goes in tax free: The contribution is deposited into your account before taxes are applied to your Am I Eligible to Participate? paycheck making your savings immediate. In order to contribute you must be: 2. Money comes out tax free: Eligible health care purchases can be made tax free when you use your – Enrolled in a qualified HDHP account. Purchases can be made directly either by using your Debit Card provided by ConnectYourCare or through In addition you must not be: online bill pay. You can also pay out of pocket and reimburse yourself from the account. – Covered under a secondary health plan that is not a 3. Funds earn interest—tax free: The interest on your qualified HDHP, including a full purpose Flexible Spending funds grows on a tax free basis. And, unlike most savings Account through your employer, parent or spouse. accounts, interest earned on your health savings account is not considered taxable income when the funds are used for – Enrolled in Medicare eligible health care expenses. – Another person’s tax dependent What Happens to the Money in My Account If I Can I Change My Contributions Throughout No Longer Have HDHP Coverage? the Year? Once you discontinue coverage under an HDHP and/or get Yes, contact Human Resources. secondary coverage that disqualifies you, you can no longer make contributions to your account. However, since you still How Much Can I Contribute? own the account, you can continue to use the remaining funds for future health care expenses. Contributions from you and the City cannot exceed $3,600 for individuals or $7,200 for individuals + dependents. Individuals Can I Rollover or Transfer Funds From Another aged 55 and over may make up to an additional $1,000 catch- Health Savings Account into My New Account? up contribution annually. Yes, those monies may be rolled into your new account and will Do I Have to Spend All of My Contributions by continue their tax free status. the End of the Plan Year? No, unused money in your account rolls over and continues to grow tax free. What Happens If My Employment Is Terminated? Money in your account is yours to keep, the account belongs to you. 8

Health Savings Account (HSA) Contributions to the HSA are limited by the amount established 2021 HSA Maximum Contributions by IRS guidelines. The HSA maximum contribution levels for 2021 are $3,600 for employee only and $7,200 for employee + Employee Only $3,600 family. For 2022 are $3,650 for employee only and $7,300 for employee + family. Individuals can use tax-free HSA dollars for Employee + Family $7,200 qualified medical expenses. Catch-Up (55+ Years) $1,000 Individuals who are 55 years of age or older and not on Medicare can make catch-up contributions up to $1,000. 2022 HSA Maximum Contributions Your contributions are pre-tax and can be funded: Employee Only $3,650 – Electronically through payroll deduction (this is required to Employee + Family $7,300 receive any pre-tax benefit). Catch-Up (55+ Years) $1,000 – Directly to the account by you: City HSA Contribution  At the end of the year. HDHP HSA BS&W Preferred $1,460  As claims are incurred. HDHP HSA BS&W + Cigna $500  On a one time, monthly or quarterly basis. Note: Deposits will need to be reported on your IRS tax form the following year. Please be careful not to exceed the non-taxable IRS contribution level. The HSA is administered through Connect Your Care. Connect Your Care will provide you with tax forms at the end of the year to submit with a 1040. All medical expense receipts need to be retained by you to document eligible distributions. HSA distributions are tax-free for qualified expenses if taken by you, your spouse or dependent(s). Your spouse or dependents do not need to be covered by a high deductible health plan (HSA plans). If the HSA funds are not used for qualified medical expenses, then the amount is included as income and a 20% penalty is applied by the IRS. HSA funds can be withdrawn by using a debit card or a check. (Note: Some reimbursement methods may require additional service fees charged by ConnectYourCare.) 9

Medical Benefits HMO & PPO Health Plan Summary The City of Temple offers HMO & PPO medical plan options through Scott & White Health Plan. The chart below gives a summary of the 2021-2022 Medical coverage. Please refer to your Summary of Benefits & Coverage for full coverage details. BS&W PREFERRED PLAN PPO BS&W + CIGNA PLAN (Employee Pays) (Employee Pays) In-Network Out-of-Network In-Network Out-of-Network ANNUAL DEDUCTIBLE (PLAN YEAR) Individual $1,500 Not Covered $1,500 $3,000 Not Covered $3,000 $7,000 Family $3,000 Not Covered 80% 50% Coinsurance (Plan Pays) 80% Not Covered Not Covered ANNUAL OUT-OF-POCKET MAXIMUM (Includes Deductible) Not Covered Individual $2,500 Not Covered $2,500 $5,000 $5,000 $20,000 Family $5,000 Lifetime Maximum Unlimited Unlimited COPAYS / COINSURANCE Preventive Care No Charge No Charge Not Covered Physician Office $25 copay Not Covered $25 copay $35 copay Specialist Office $45 copay Not Covered $45 copay $55 copay Telemedicine No Charge Not Covered No Charge Not Covered Virtual Visits The amount of the deductible or Not Covered The amount of the deductible or Not Covered copay may not exceed the copay may not exceed the amount Urgent Care amount of the deductible or Not Covered of the deductible or copay required Emergency Room Not Covered Hospital - Inpatient copay required for a comparable Not Covered for a comparable medical service Hospital - Outpatient medical service provided Not Covered provided through a face-to-face Diagnostic X-Ray through a face-to-face Not Covered (No cost if performed as part consultation consultation of a physician visit) Diagnostic Lab $100 copay $100 copay (No cost if performed as part $350 copay of a physician visit) 20% after deductible $350 copay Complex Imaging 20% after deductible (CT Scans/MRIs) 20% after deductible 50% after deductible 20% after deductible 20% after deductible 50% after deductible 20% after deductible 20% after deductible 50% after deductible 20% after deductible 20% after deductible 50% after deductible 20% after deductible 50% after deductible 10 Utilizes BSW Extended PPO Network

Pharmacy Benefits BS&W Preferred PRESCRIPTION DRUGS In-Network Out-of-Network RETAIL (34 DAY SUPPLY) Deductible Participating Pharmacy Non-Participating Pharmacy Preferred Generic $100 n/a Preferred Brand $10 copay n/a Non-Preferred Brand $30 copay n/a Lesser of $60 copay or 50% n/a MAINTENANCE QUANTITY Preferred Generic $25 copay n/a Preferred Brand $75 copay n/a Non-Preferred Brand Lesser of $150 copay or 50% n/a OUTPATIENT SPECIALTY DRUGS (MEDICAL DIRECTOR APPROVAL REQUIRED) n/a Lesser of $75 or 30% PPO BS&W + CIGNA PRESCRIPTION DRUGS In-Network Out-of-Network RETAIL (34 DAY SUPPLY) Deductible Participating Pharmacy Non-Participating Pharmacy Preferred Generic $100 50% $10 copay 50% Preferred Brand $30 copay 50% $30 copay 50% Non-Preferred Brand MAINTENANCE QUANTITY $25 copay 50% (90 DAY SUPPLY) 50% 50% Preferred Generic 50% Preferred Brand $75 copay Non-Preferred Brand $75 copay OUTPATIENT SPECIALTY DRUGS (MEDICAL DIRECTOR APPROVAL REQUIRED) 30% to a maximum of $75 Note: Please refer to Summary Plan Description for a full outline of your medical coverage. 11

Pharmacy Benefit FAQs— Cigna Plans Q: Am I required to fill maintenance medications for 90 days at a time? A: Maintenance medications can be filled at a local retail pharmacy once before being required to use the Cigno90 Now Network. There are many local retail options in the Cigna90 Now network. Also filling maintenance prescriptions for a 90-days will require employees to make fewer trips to the pharmacy for refills. Also, employees are likely to stay healthy because with a 90-day supply on-hand, they will be less likely to miss a dose. Q: Am I required to fill maintenance medications through mail order? A: Your plan also offers a retail pharmacy network that gives employees choices in where 90-day prescriptions can be filled. There are thousands of retail pharmacies in your network. They include local pharmacies, grocery stores, retail chains and wholesale warehouse stores. If you prefer the convenience of having your medications delivered to your home, you can also use Cigna Home Delivery Pharmacy to fill your prescriptions. Q: Can I track my mail order prescription status on-line? A: Yes, go to myCigna.com. It gives you 24/7/365 access to: See your pharmacy claim history, Read your benefit details, See medication prices based on your plan, Manage your Cigna Home Delivery Pharmacy orders, Ask a pharmacist a question Q: What retail pharmacies can I use to fill my maintenance medications? A: For more information about your pharmacy network, employees can go to Cigna.com/Rx90network. Some of the 90-day retail pharmacies in your network: BSW Pharmacies CVS (including Target) Walmart Q: Am I required to fill specialty medications through mail order? A: The preferred pharmacy for specialty medications is Accredo, a Cigna specialty pharmacy. If you’re taking a specialty medication to treat a complex medical condition, Accredo’s team of specialty trained pharmacists and nurses can help. They’ll fill and ship your specialty medication to your home (or location of your choice). They’ll also provide employees with the personalized care and support you need to manage your therapy - at no extra cost. Easily manage and track your medications on your phone or online , Fast shipping, at no extra cost, Easy refills and free reminders 24/7 access to specialty-trained pharmacists and nurses, Personalized care services like training on how to administer your medication Help with applying for third-party copay assistance programs and other options To get started using Accredo, call 877.826.765 Q: What is the process to fill specialty medications? A: To get started using Accredo, call 877.826.7657, Monday-Friday, 7:00 am-10:00 pm CST and Saturdays, 7:00 am-10:00 pm CST. Be sure to call Accredo about two weeks before your next refill so they have time to get a new prescription from your doctor’s office. To learn more about Accredo, go to Cigna.com/specialty. Q: Where can I find the estimated drug cost for my medication? A: Log in to the myCigna App or myCigna.com and use the Price a Medication tool to see how much your medication costs before you get to the pharmacy counter - or, even before you leave your doctor’s office. Q: Where can I find a list of medications that are considered specialty? A: Employees can find the drug formulary by clicking the link below, then selecting the Performance 3 Tier drug list: https:// www.cigna.com/drug-list Q: Am I required to fill my prescriptions with generic drugs unless otherwise authorized? A: Whether the employee or their physician requests brand when a generic equivalent is available, the employee is responsible for paying the brand copay plus the difference between the cost of the brand and the generic amount (up to the cost of the brand name drug). 12

Medical Insurance Waiver & Wellness Incentives PLEASE NOTE FOR THE 2021-2022 PLAN YEAR THE CITY WILL ONLY REQUIRE A TOBACCO ATTESTATION FORM. TOBACCO FREE All Employees enrolled in medical coverage are eligible for a medical insurance premium incentive if they and their dependents do not use tobacco or nicotine products in any form. Tobacco Free Incentive $40 per month WAIVER All employees who waive medical coverage through the City of Temple will receive either $125 deposited monthly into their ICMA account OR $100 monthly included in their paycheck. Proof of other qualified insurance coverage is required in order to receive the waiver incentive. All documentation must be submitted prior to the first day of the new benefit year. Late submissions will not receive retroactive incentive payment, and the first incentive will be paid on the paid period following receipt of the documentation. 13

Medical Benefits Medical Premiums Below are the Medical rates for Scott & White medical plans. Premium contributions for Medical will be deducted from your paycheck on a pre-tax basis. Your level of coverage will determine your semi-monthly contributions, and all below rates assume all wellness incentives. HDHP HSA BS&W PREFERRED Monthly City Base Incentive Total City Employee Employee Premium Contribution Contribution Monthly Semi-Monthly Contribution Contribution CONTRIBUTIONS Employee Only $397.39 $357.39 $40.00 $397.39 $0.00 $0.00 Employee + Spouse $769.53 $529.53 $40.00 $569.53 $200.00 $100.00 Employee + Child(ren) $546.75 $456.75 $40.00 $496.75 $50.00 $25.00 Employee + Family $957.20 $567.20 $40.00 $607.20 $350.00 $175.00 HDHP HSA BS&W + CIGNA Monthly City Base Incentive Total City Employee Employee Premium Contribution Contribution Monthly Semi-Monthly Contribution Contribution $524.86 CONTRIBUTIONS $1,016.38 $464.86 $40.00 $504.86 $20.00 $10.00 Employee Only $722.14 $576.38 $40.00 $616.38 $400.00 $200.00 Employee + Spouse $1,264.25 $557.14 $40.00 $597.14 $125.00 $62.50 Employee + Child(ren) $624.25 $40.00 $664.25 $600.00 $300.00 Employee + Family BS&W PREFERRED Monthly City Base Incentive Total City Employee Employee Premium Contribution Contribution Monthly Semi-Monthly Contribution Contribution $527.04 $427.04 CONTRIBUTIONS $1,020.59 $480.59 $40.00 $467.04 $60.00 $30.00 Employee Only $725.13 $510.13 $40.00 $520.59 $500.00 $250.00 Employee + Spouse $1,269.50 $529.50 $40.00 $550.13 $175.00 $87.50 Employee + Child(ren) $40.00 $569.50 $700.00 $350.00 Employee + Family City Base Contribution PPO BS&W + CIGNA $467.38 Monthly $582.96 Incentive Total City Employee Employee Premium $564.44 Contribution Monthly Semi-Monthly $643.44 Contribution Contribution $657.38 CONTRIBUTIONS $1,272.96 $40.00 $507.38 $150.00 $75.00 Employee Only $904.44 $40.00 $622.96 $650.00 $325.00 Employee + Spouse $1,583.44 $40.00 $604.44 $300.00 $150.00 Employee + Child(ren) $40.00 $683.44 $900.00 $450.00 Employee + Family 14

Know Where to Go 15

Dental Benefits Dental Plan Summary The chart below gives a summary of the 2021-2022 Dental coverage provided by Standard. Employees have the option to choose between two dental plan options. You may see any dentist, however in-network providers have agreed to accept reduced fees for services. All out-of-network services are subject to Usual and Customary (U&C) limitations. Standard Plan Buy-Up Plan In-Network Out-of-Network In-Network Out-of-Network ANNUAL DEDUCTIBLE $0 $50 $0 $150 Individual $750 $1,500 Family 100% MAC 100% 100% of U&C ANNUAL MAXIMUM BENEFIT 50% MAC 80% 80% of U&C Per Person 25% MAC 50% 50% of U&C COVERED SERVICES Preventive Services Oral Exams, X-Rays, Bitewing X-Rays, Routine Cleanings, Fluoride Treatments, Sealants Basic Services* Fillings, Simple extractions, Endodontics, Periodontics, Anesthesia, Complex Oral Surgery Major Services* Implants, Inlays, Onlays, Crowns, Prosthodontics Orthodontia None 50% (Child & Adult) Orthodontia Lifetime Maximum N/A $1,500 Lifetime Maximum (per individual) *After Deductible MAC ( Maximum Allowable Charge) All employees who waive dental coverage and have an active Flexible Spending Account will receive $10 per month into their FSA account from the City of Temple. 16

Dental Benefits Dental Premiums Dental Plan benefits are available to you on a voluntary basis. Premium contributions for Dental will be deducted from your paycheck on a pre-tax basis. Your level of coverage will determine your semi-monthly contributions. STANDARD PLAN Monthly Premium City Contribution Employee Monthly Employee Contribution Semi-Monthly $12.50 Contribution CONTRIBUTIONS $24.73 $10.00 $2.50 Employee Only $30.76 $10.01 $14.72 $1.25 Employee + Spouse $44.51 $10.00 $20.76 $7.36 Employee + Child(ren) $10.01 $34.50 $10.38 Employee + Family $17.25 BUY-UP PLAN Monthly Premium City Contribution Employee Monthly Employee Contribution Semi-Monthly $28.61 Contribution CONTRIBUTIONS $57.64 $10.01 $18.60 Employee Only $77.81 $10.00 $47.64 $9.30 Employee + Spouse $106.86 $10.01 $67.80 $23.82 Employee + Child(ren) $10.00 $96.86 $33.90 Employee + Family $48.43 Finding a Dentist – Visit www.standard.com/services, then click on the “Find a Dentist” on the home page and search the directory. – You can search by specialty, county ZIP code, street address or dentist name. – In Texas, network and plans are the Ameritas Dental Network (Ameritas Classic PPO). 17

Vision Benefits Vision Plan Summary The chart below gives a summary of the 2021-2022 Vision coverage provided by Standard. Periodic eye examinations are an important part of routine preventive healthcare. All out-of-network services are reimbursement levels. In-Network Vision Plan Out-of-Network (Reimbursement Amount) COPAY $10 copay Up to $45 Examination COVERED MATERIALS Covered in Full Up to $30 allowance LENSES Covered in Full Up to $50 allowance Single Vision Covered in Full Up to $65 allowance Bifocal Up to $100 allowance Trifocal Covered in Full Up to $50 allowance Lenticular Progressive Contracted Fee for Bifocals Standard Lens Reimbursement 20% Discount off Retail + Specialty Lenses Standard Lens Allowance FRAMES $150 allowance + 20% discount Up to $70 allowance Retail Frame Equivalent CONTACTS $150 allowance Up to $120 allowance Elective Contact Lenses Covered in full Up to $210 allowance Medically Necessary FREQUENCY Every 12 Months Examination Every 12 Months Lenses Every 24 Months Frames Every 12 Months Contacts 18

Vision Benefits Vision Premiums Vision Plan benefits are available to you on a voluntary basis. Premium contributions for Vision will be deducted from your paycheck on a pre-tax basis. Your level of coverage will determine your semi-monthly contributions. VISION PLAN Employee Semi-Monthly Employee Monthly Contribution Contribution CONTRIBUTIONS $5.74 $2.87 Employee Only $10.04 $5.02 Employee + Spouse $12.16 $6.08 Employee + Child(ren) $14.92 $7.46 Employee + Family Finding a Doctor - The Standard Vision Plan utilizes the VSP network. To find a provider online, log into www.standard.com/services and search for a VSP Provider - For customer service call 1-800-877-7195. 19

Flexible Spending Account What Is the Dependent Care Account? What is a Flexible Spending Account? The Dependent Care Account allows you to put aside up to $5,000 pre-tax for your qualified dependent care expenses for You can pay for eligible health care and dependent care any dependents who live with you and rely on you for more expenses with pre-tax income through a Flexible Spending than half of their support as claimed on your taxes. Dependents Account. You do not pay federal income tax on your include: contribution.  Children under the age of 13. The Flexible Spending Account reimburses you for eligible  Persons of any age, if physically or mentally disabled, and health care expenses that are not covered by insurance. Expenses may be incurred by you, your spouse, and your claimed on your federal income tax return. dependent children, regardless of whether they are covered by the City’s medical, dental or vision plans.  You may be reimbursed for day care expenses only if this The Flexible Spending Account also reimburses you for certain enables you to work. If married, your spouse must also dependent care expenses incurred while you and/or your work or be looking for work, be a full-time student, or be spouse work. disabled. How Spending Accounts Work How Much Can I Contribute? You choose to contribute part of your earnings into the Medical Contributions cannot exceed $2,750 for the Medical and Limited Flexible Spending Account and/or the Dependent Care Flexible Purpose FSAs and $5,000 for the Dependent Care FSA. Spending Account. The accounts are maintained separately and you cannot make transfers between them. These accounts will Do I Have to Spend All of My Contributions by reimburse you for eligible expenses that you submit throughout the End of the Plan Year? the year. Yes, employees must spend all contributions in the plan year Those employees who participate in the High and will have a 75 day run out period to file for reimbursement. Deductible Health Plan with the Health Savings Account, have the opportunity to contribute pre- tax funds to a Limited Purpose Flexible Spending Account, which can be used for dental and vision expenses only.  Estimate your annual health care expenditures on items not reimbursed by insurance.  Decide how much money you want to contribute to the account up to $2,750 per year. The money is deducted before taxes, so taxes are withheld on a lower amount of your earnings (pre-tax basis).  The City offers a debit card that allows eligible expenses to be deducted directly from your account.  You may also file a paper or online claim when you have eligible health care expenses.  At the end of the year, you have a 75 day run out period to submit reimbursement for claims from the prior plan year. 20

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Income Protection Short Term Disability (STD) Long Term Disability (LTD) Short Term Disability (STD) benefits are available to you on a Long Term Disability (LTD) benefits are provided for all full time voluntary basis through Standard. STD insurance protects a City employees at no cost to you through Standard. LTD portion of your income if you become partially or totally insurance protects a portion of your income if you become disabled for a short period of time. It replaces 60% of your partially or totally disabled for an extended period of time. This income, up to a maximum weekly benefit of $1,500, depending insurance replaces 60% of your income, up to a maximum of on your current annual earnings. You have two benefit options, $5,000 per month, depending on your current annual earnings. 1) you must be sick or disabled for at least 7 days or 2) you must You must be sick or disabled for at least 180 days before you be sick or disabled for 14 days before you can receive a benefit can receive a benefit payment. Payments will last for as long as payment. Payments may last up to 26 weeks. Certain exclusions you are disabled or until you reach your Social Security Normal may apply. Please refer to your Summary Plan Description or Retirement Age, whichever is sooner. Certain exclusions, along plan certificate for details or contact Human Resources for with any pre-existing condition limitations, may apply. Please questions. refer to your Summary Plan Description or plan certificate for details or contact Human Resources for questions. Voluntary STD Long Term Disability Benefit Percentage 60% Benefit Percentage 60% Maximum Weekly Benefit $1,500 Maximum Monthly Benefit $5,000 Option 1: 7/7 Days 180 Days Elimination Period Option 2: 14/14 Days Elimination Period To Age 65 Up to 26 weeks Duration of Benefits 3 months / 12 Duration of Benefits Pre-Existing Condition months Pre-Existing Condition None Limitation 24 Months Limitation Mental Disorder/Self Reported 24

Survivor Benefits Life Insurance The City of Temple provides all full time employees with Basic Life / AD&D Insurance at no cost to you through Standard. Employees also have the option to purchase additional voluntary life insurance for themselves, their spouse and their dependent children. In order to purchase coverage for dependents, an employee must elect coverage for themselves. Basic Group Term Life / AD&D (Paid for by the City) All Full Time Employees Eligibility Life Benefit Amount One Times Annual Salary to a Maximum of $100,000 AD&D Benefit Amount One Times Annual Salary to a Maximum of $100,000 Voluntary Life / AD&D (Paid for by employee) All Full Time Employees Employee: $10,000 increments to $300,000 maximum Eligibility Spouse: $5,000 increments to $150,000 maximum Life Benefit Amount Children: $10,000 Guarantee Issue* Employee: $150,000 Conversion Spouse: $50,000 Children: All Guarantee Issue Included *Any coverage *Guarantee Issue is available at initial eligibility the Guarantee Issue amount(s) will be subject to evidence of insurability. 25

Additional Voluntary Benefits Premiums are paid by employee and will vary based on plan selected and employee age. Both plans are offered through Standard. Critical Illness Insurance Accident Insurance Facing a critical illness is difficult. There is so much to think You do everything you can to keep your family safe, but about – from deciding between your treatment options to accidents do happen. When they do, it’s good to know you have managing your family’s everyday needs to maintaining your help to manage the unexpected bills that come with them. The financial and emotional stability. City of Temple Critical Illness City of Temple Accident insurance is designed to cover insurance can provide immediate financial relief from the unexpected expenses that result from all kinds of accidents. overwhelming expenses of a serious illness, such as a heart Your benefits come directly to you without any restrictions on attack, stroke or organ failure. It pays a lump-sum cash benefit how you can use them. You can’t predict when unexpected when you are diagnosed with a covered illness easing your accidents will happen, but you can help protect your family from financial worries. In short, The City of Temple Critical Illness the expenses accidents bring with them. The City of Temple insurance can provide a financial cushion to help you manage Accident insurance provides a financial cushion to help you take your illness, your way. It’s that simple. care of bills, so you can take care of each other. It’s that simple. Voluntary Critical Illness Voluntary Accident Benefit EE: $5,000 increments to $30,000 Emergency Care $300 SP: $5,000 increments to $30,000 Ambulance $800 Guarantee Issue Air Ambulance $50 CH: 50% of Employee Benefit Accident Physician Office $150 Heart Attack Accident ER Treatment $200 Stroke Employee: $30,000 Major Diagnostic Exam $50 Heart Failure Spouse: $30,000 X-ray Cancer $1,000 Kidney Failure Child: 50% of EE Amount Treatment Care $200 Major Organ Failure Hospital Admission $200 Paralysis 100% Hospital Confinement Daily Benefit $150 100% Intensive Care Unit Daily Benefit $175 100% Transportation for Care (30 days) 100% Companion Lodging (30 days) Schedule up to $8,000 depending on 100% Fractures location and whether 100% 100% Dislocations open/closed Alzheimer’s Disease 100% Schedule up to Advanced Parkinsons 100% $5,000 depending on Coma 100% Loss of Sight 100% location Loss of Hearing 100% Pre-Existing Condition None Accidental Death & Dismemberment $50,000 Health Screening $50 $25,000 Employee $12,500 Spouse Child 26

Additional Voluntary Benefits Hospital Indemnity Insurance Employees have the opportunity to elect Voluntary Hospital Indemnity through Standard. Hospital Indemnity Insurance is a comprehensive plan that provides direct payment to you when hospitalization due to accident or sickness. Below shows an example of the Hospital Indemnity offering. Voluntary Hospital Indemnity HOSPITAL INDEMNITY PAID TO EMPLOYEE Hospital Admission $1,000 Critical Care Admission* $500 Hospital $100/day (15 days) Confinement $50/day (15 days)* Non-ICU Critical Care Unit* Health Screening $50 Pre-Existing None Condition *Critical Care Unit Benefit Pays In addition to Non-ICU Confinement Benefit 27

Employee Assistance Program 28

Employee Assistance Program 29

Retiree Benefits THE CITY OF TEMPLE IS PLEASED TO ANNOUNCE YOUR 2021-2022 BENEFIT PLANS. PLEASE REVIEW YOUR PLAN OPTIONS BEFORE MAKING YOUR FINAL PLAN ELECTIONS. FURTHER DETAILS ABOUT ALL OF YOUR PLANS ARE INCLUDED IN THIS ENROLLMENT GUIDE. PLEASE REVIEW YOUR CHOICES CLOSELY, AS YOU WON’T BE ABLE TO MAKE CHANGES TO YOUR ELECTIONS UNTIL NEXT OPEN ENROLLMENT. WHEN CAN I ENROLL? At Retirement: You must enroll within thirty (30) days of your retirement effective date. If you do not enroll or you reject coverage for any benefit, you will not be eligible to enroll in that benefit in the future. Medical The City of Temple offers retirees a choice of four medical plans through Baylor, Scott & White Health Plan. Two plans have copayments for services provided in a doctor’s office and for most prescription drugs. For services in a hospital or outpatient setting, there will be a deductible that you will be responsible to pay. The remaining two plans are High Deductible Health Plans, and members will be responsible for the contracted rate until applicable deductibles have been met. The City contributes $200 per month for all retirees with 25+ years of service. Dental Retirees may choose to enroll in one of two dental plans offered through Standard. Both offer benefits for contracted and non-contracted dentists. Please see the following two pages for retiree rates for medical and dental. Reminder: Retirees may change health plan and dental plan elections, however retirees are not eligible to enroll in a plan they are not currently enrolled in. In addition, retirees are not eligible to add dependents to their plan if the dependent is not currently enrolled. Retirees are eligible for coverage until the age of 65.Upon attaining age 65, retirees are eligible to enroll in the Medicare Supplement Plan (Senior Care) and are no longer eligible for the current group coverage. 30

Retiree Medical Rates HDHP HSA BS&W PREFERRED Monthly Premium City Contribution Retiree Monthly Contribution (Retirees with less than 25 years of (Retirees with 25+ Years of (Retirees with 25+ Years of Service) Service) Service) CONTRIBUTIONS $596.10 $200 $396.10 Retiree Only $1,154.30 $200 $954.30 Retiree + Spouse $820.13 $200 $620.13 Retiree + Child(ren) $1,435.80 $200 $1,235.80 Retiree + Family $596.10 $0.00 $596.10 Retiree Spouse Only HDHP HSA BS&W + CIGNA Monthly Premium City Contribution Retiree Monthly Contribution (Retirees with less than 25 years of (Retirees with 25+ Years of (Retirees with 25+ Years of service) Service) Service) CONTRIBUTIONS $787.29 $200 $587.29 Retiree Only $1,524.57 $200 $1,324.57 Retiree + Spouse $1,083.21 $200 $883.21 Retiree + Child(ren) $1,896.39 $200 $1,696.39 Retiree + Family $787.29 $0.00 $787.29 Retiree Spouse Only Monthly Premium BS&W PREFERRED Retiree Monthly Contribution CONTRIBUTIONS (Retirees with less than 25 years of (Retirees with 25+ Years of Retiree Only City Contribution Service) Retiree + Spouse Service) (Retirees with 25+ Years of Retiree + Child(ren) Retiree + Family Service) Retiree Spouse Only $784.75 $200 $584.75 CONTRIBUTIONS $1,519.64 $200 $1,319.64 Retiree Only $1,079.68 $200 $879.68 Retiree + Spouse $1,890.24 $200 $1,690.24 Retiree + Child(ren) $784.75 $0.00 $784.75 Retiree + Family Retiree Spouse Only Monthly Premium PPO BS&W + CIGNA Retiree Monthly Contribution (Retirees with less than 25 years of (Retirees with 25+ Years of City Contribution Service) Service) (Retirees with 25+ Years of Service) $986.06 $200 $786.06 $1,909.45 $200 $1,709.45 $1,356.65 $200 $1,156.65 $2,375.13 $200 $2,175.13 $986.06 $0.00 $986.06 31

Retiree Dental Rates Monthly Premium STANDARD BASE PLAN Retiree Monthly Contribution (Retirees with less than 25 years of (Retirees with 25+ Years of City Contribution Service) Service) (Retirees with 25+ Years of $6.61 Service) $18.84 $24.87 CONTRIBUTIONS $12.50 $5.89 $38.62 Retiree Only $24.73 $5.89 Retiree + Spouse $30.76 $5.89 Retiree + Child(ren) $44.51 $5.89 Retiree + Family STANDARD BUY-UP PLAN Monthly Premium City Contribution Retiree Monthly Contribution (Retirees with less than 25 years of (Retirees with 25+ Years of (Retirees with 25+ Years of Service) Service) Service) $22.72 CONTRIBUTIONS $28.61 $5.89 $51.75 Retiree Only $57.64 $5.89 $71.92 Retiree + Spouse $77.81 $5.89 $100.97 Retiree + Child(ren) $106.86 $5.89 Retiree + Family 32

Glossary and the account is portable, meaning if you change jobs your account goes with you. Allowed Fees Incurred Expense Term used by some dental plans for their participating dentist fees and / or maximum payable for a non-participating dentist. Calendar Year An expense is considered incurred on the date services were rendered or supplies were received. January 1st through December 31st of each year. Initial Enrollment Period COBRA The first 15 days of fulltime employment or 30 days from a Consolidated Omnibus Budget Reconciliation Act of 1985. This covered life event. Act requires that continuation of group insurance be offered to covered persons who lose health, dental or vision coverage due In-Network to a qualifying life event as defined in the Act. In-network providers are doctors, hospitals and other providers Coinsurance that contract with your insurance company to provide health care services at discounted rates. The portion of covered health care costs for which the covered person is financially responsible, usually according to a fixed Medical Emergency percentage. Co-insurance may be applied after a deductible requirement is met. A sudden, serious, unexpected and acute onset of an illness or injury where a delay in treatment would cause irreversible Copay deterioration resulting in a threat to the patient’s life or body part. The charge you are required to pay for certain covered health services, such as a prescription or office visit. Out-of-Network Deductible Out-of-network providers are doctors, hospitals and other providers that are not contracted with your insurance company. The amount you must pay for covered health services based on If you choose an out-of-network doctor, services will not be contracted rates (also referred to as eligible charges/expenses) provided at a discounted rate. in a year before the plan will begin paying certain benefits in that year. Out-of-Pocket Maximum Explanation of Benefits (EOB) The maximum amount of co-insurance you pay every year. Once you reach the out-of-pocket maximum, as an individual or A statement sent by your insurance carrier that explains which family, benefits for those covered health services that apply to procedures and services were provided, how much they cost, the out-of-pocket maximum are paid at a percent of eligible what portion of the claim was paid by the plan, and what charges during the rest of that year. Deductibles and copays portion is your liability, in addition to how you can appeal the apply to the out-of-pocket maximum. insurer’s decision. These statements are also posted on the carrier’s website for your review. Plan Year Flexible Spending Accounts (FSAs) October 1, 2021 through September 30, 2022. An option that allows participants to set aside pre-tax dollars to Portability pay for certain qualified expenses during a specific time period (usually a 12-month period). There are two types of FSAs: the You keep the account even if you change Insurance plans / jobs Health Care FSA and the Dependent Care FSA. or retire. Guarantee Issue Usual and Customary Rates (U&C) The amount of coverage pre-approved by the Life Insurance Out-of-network health plan expenses are considered for Company regardless of health status. reimbursement at usual and customary (U&C) rates. U&C rates are determined to be the prevailing charge made for a service Health Savings Account (HSA) by a similar provider in the same geographic area. Charges above U&C are not covered by the plan and are the A personal health care bank account funded by your or your responsibility of the participant employer’s tax-free dollars to pay for qualified Medical expenses. You must be enrolled in a CDHP / HDHP to open an HSA. Funds contributed to an HSA roll over from year to year 33

Important Notices Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, contact your State Women’s Health and Cancer Rights Act Medicaid or CHIP office or dial 1-877-KIDS NOW or www.insurekidsnow.gov to find out how to apply. If you If you have had or are going to have a mastectomy, you may be qualify, ask your state if it has a program that might help you entitled to certain benefits under the Women’s Health and pay the premiums for an employer-sponsored plan. Cancer Rights Act of 1998 (WHCRA). For individuals receiving mastectomy related benefits, coverage will be provided in a If you or your dependents are eligible for premium assistance manner determined in consultation with the attending physician under Medicaid or CHIP, as well as eligible under your and the patient, for: employer plan, your employer must allow you to enroll in your employer plan if you aren’t already enrolled. This is called a – All stages of reconstruction of the breast on which the “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for mastectomy was performed; premium assistance. If you have questions about enrolling in your employer plan, contact the Department of Labor at – Surgery and reconstruction of the other breast to produce a www.askebsa.dol.gov or call 1-866-444-EBSA (3272). To see symmetrical appearance; if any other states have added a premium assistance program since January 31, 2019, or for more information – Prostheses; and on special enrollment rights, contact either: – Treatment of physical complications of the mastectomy, U.S. Department of Labor Employee Benefit Security Administration including lymphedema. www.dol.gov/agencies/ebsa 1-866-444-EBSA (3272) These benefits will be provided subject to the same deductibles and coinsurance applicable to other medical and surgical U.S. Department of Health and Human Services benefits provided under this plan. If you would like more Centers for Medicare & Medicaid Services information on WHCRA benefits, call your plan administrator as www.cms.hhs.gov identified at the end of these notices. 1-877-267-2323, menu Option 4, Ext. 61565 Newborn’s and Mother’s Health Protection Act Coverage After Termination (COBRA) (NMHPA) Continuation of Health Coverage The Newborn’s and Mother’s Health Protection Act (NMHPA) If you or your dependents have coverage at the time of a restricts limiting the length of a hospital stay in connection with qualifying event, you may be eligible to elect continuation of childbirth for a mother or newborn child to less than 48 hours (or coverage under one or more of the following: 96 hours for a cesarean delivery). The law does not prohibit earlier discharge if the mother and her attending physician are – Medical Plan in agreement that an earlier discharge is appropriate. In addition, authorization of the hospital stay cannot be required – Dental Plan for stays of 48 hours or less (or 96 hours) nor are early discharge incentives allowed. Hospital stays begin at delivery or upon hospital admission (whichever is later). Medicaid and the Children’s Health Insurance – Vision Plan Program (CHIP) You have a legal right under the Consolidated Omnibus Budget If you or your children are eligible for Medicaid or CHIP and Reconciliation Act of 1985 (COBRA) to purchase a temporary you’re eligible for health coverage from your employer, your extension of your coverage at group rates. However, you must state may have a premium assistance program that can help pay the full cost of the coverage, plus a 2% administrative fee. pay for coverage, using funds from their Medicaid or CHIP programs. If you or your children aren’t eligible for Medicaid or COBRA Continuation Coverage CHIP, you won’t be eligible for these premium assistance programs but you may be able to buy individual insurance COBRA continuation coverage is a continuation of Plan coverage through the Health Insurance Marketplace. For more coverage when it would otherwise end because of a life event. information, visit www.healthcare.gov. This is also called a “qualifying event.” Specific qualifying events are listed later in this notice. After a qualifying event, COBRA If you or your dependents are already enrolled in Medicaid or continuation coverage must be offered to each person who is a CHIP and you live in a State listed below, contact your State “qualified beneficiary.” You, your spouse, and your dependent Medicaid or CHIP office to find out if premium assistance is children could become qualified beneficiaries if coverage under available. the Plan is lost because of the qualifying event. Under the Plan, qualified beneficiaries who elect If you or your dependents are NOT currently enrolled in 34